Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 209190 | NY |
NPI | 1043388424 |
---|---|
Provider Name | Dr. Emma Benjamin |
First Address | Rego Park, NY 11374-2654 |
Second Address | Brooklyn, NY 11236-3530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01898420 | (05) | NY |
G84343 | (02) | NY |